University of Southern California Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy
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Medical Treatments

When health care professionals treat patients for a particular illness or condition, they usually follow practice guidelines that are put together by committees of physicians, nurses, occupational and physical therapists, researchers and other people who are experienced and knowledgeable about the subject. This certainly applies to treating pressure ulcers (which means the same thing as "pressure sores" or "bedsores"). There are many treatment choices for each condition. In providing the best care to people with spinal cord injuries who develop pressure ulcers, the physician choose a treatment that applies properly to their patients. Listed below are some common procedures for pressure ulcers at various stages, locations and/or sizes; each of these were experienced by at least one of the people who took part in our study. Remember, these are just examples; your doctor will help you determine the treatment that is right for you.

Symptoms At This Stage Treatments Usually Recommended, Depending on Individual Case 1 2 Study Participants Who Had This Treatment
Stage 1 Redness (on darker skin, purpleness); swelling; warmth

Doctor: examine wound to confirm condition; reassess every 2 to 4 weeks, especially if wound is not healing.

Home care: keep pressure off area (usually bedrest, use of cushions), good nutrition, and keep skin clean.

Alley, Alma, Helen, Judy
Stage 2 Some opening in skin, but not very deep; looks like a scrape, blister, "zit" or crater

Doctor: same as above, plus debridement; clean with medicated solution; giving or prescribing medications and antibiotic ointment or cream; give home care instructions.

Home care: change dressing per instructions; good nutrition; use prescribed medications and/or antibiotic cream; keep pressure off wound (usually bedrest).

Alley, Brenda, Frank, Rachel
Stage 3 Skin broken, with damage down to underlying layer of tissue

Doctor: same as above, plus possibility of skin graft, electrical stimulation to promote wound healing and/or hospitalization.

Home care: after hospitalization, continue medications, keeping pressure off wound and regular doctor's appointments until doctor confirms it is completely healed.

Ken, Odel
Stage 4 Skin open, with tissue damaged down to muscle, bone or tendon

Doctor: same as above, plus skin graft, muscle flap surgery, or other surgical procedure; hospitalization, usually followed by rehabilitation and/or discharge to nursing home.

Home care: after hospital and rehabilitation, continue medications, keeping pressure off wound and regular doctor's appointments until doctor confirms it is completely healed.

Alley, Brenda, Charlie, Chris, Dave, Frank, Gary, Helen, Howard, Judy, Ken, Mitch, Rachel, Robert, Tom

If your doctor recommends a procedure that you are unfamiliar with, it's a good idea to ask for a clear explanation of what is involved. You may even want to consult with another doctor, especially if there is someone who is very familiar with your case, or do some research for yourself. If you use the Internet, a helpful website that lists many of the standard and alternative medical treatments for pressure ulcers, along with illustrations of pressure ulcers and links to more Internet sites that may help you, is an excellent ad-free site maintained by the University Health Care System, in Augusta, Georgia. The information on that website is provided by Healthwise, which also supplies information to WebMD, a website run by the publicly-traded company WebMD Corporation, that displays ads along with health information.

If you are looking for a new medical professional or a new rehabilitation center to go to, try this useful web page about Finding a Rehab. It lists questions to ask yourself - or the health care providers - when you are checking out alternatives. (This website is maintained by a person who has a spinal cord injury himself.) Another good guide is Changing or Choosing Your Doctor, an article on the website maintained by Craig Hospital, a rehabilitation facility in Denver, Colorado.

1 Dharmarajan, T. S., & Ahmed, S. (2003). The growing problem of pressure ulcers: Evaluation and management for an aging population. Postgraduate Medicine, 113, (5), 77-90.

2 Consortium for Spinal Cord Medicine. (2000). Pressure ulcer prevention and treatment following spinal cord injury: A clinical practice guideline for health-care professionals. Washington, DC: Paralyzed Veterans of America.